National treatment trends among older patients with T1-localized renal cell carcinoma 1 1Dr. Simon P. Kim is supported by a career development award from the Conquer Cancer Foundation from the American Society of Clinical Oncology

Simon P. Kim, Cary P. Gross, Neal Meropol, Alexander Kutikov, Marc C. Smaldone, Nilay D Shah, James B. Yu, Sarah Psutka, Jonathon Kiechle, Robert Abouassaly

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To assess the national trends in treatment of localized renal tumors among older patients with limited life expectancy. Materials and methods: Using the National Cancer Database, we identified older patients (≥70. y) diagnosed with T1 renal cell carcinoma from 2002 to 2011. Primary outcome was the initial treatment-partial nephrectomy (PN), radical nephrectomy, EM, and ablation. Multivariable logistic regression analysis stratified by tumor size (<2, 2-3.9, or 4-7. cm) and age groups (70-79 and ≥80. y) was used to identify covariates associated with different treatments. Results: Among 41,518 older patients with T1 renal cell carcinoma renal tumors, most were treated with radical nephrectomy (59.0%) followed by PN (20.0%) and ablation (8.4%). Only 12.6% were managed by EM. Among older patients aged 70 to 79 years with renal tumors 2 to 3.9. cm, PN was used more frequently in 2008 to 2009 (odds ratio [OR] = 1.32; . P = 0.001) and 2010 to 2011 (OR = 1.87; . P<0.001) compared to 2002 to 2003 and at academic hospitals (OR = 1.91; . P<0.001) compared to community hospitals. Similar trends were observed for patients aged 70 to 79 years with 4 to 7. cm tumors and for patients aged≥80 years across renal tumor sizes. Conclusions: Among older patients with localized renal tumors and limited life expectancy, most are treated surgically with a growing use of PN. A smaller proportion of older patients are managed by EM in the United States.

Original languageEnglish (US)
JournalUrologic Oncology: Seminars and Original Investigations
DOIs
StateAccepted/In press - Jul 3 2016

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Nephrectomy
Neoplasms
Kidney
Odds Ratio
Therapeutics
Life Expectancy
Renal Cell Carcinoma
Renal cell carcinoma 1
Community Hospital
Age Groups
Logistic Models
Regression Analysis
Databases

Keywords

  • Advanced age
  • Kidney cancer
  • Nephrectomy
  • Renal cell carcinoma
  • Treatment decisions

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

National treatment trends among older patients with T1-localized renal cell carcinoma 1 1Dr. Simon P. Kim is supported by a career development award from the Conquer Cancer Foundation from the American Society of Clinical Oncology. / Kim, Simon P.; Gross, Cary P.; Meropol, Neal; Kutikov, Alexander; Smaldone, Marc C.; Shah, Nilay D; Yu, James B.; Psutka, Sarah; Kiechle, Jonathon; Abouassaly, Robert.

In: Urologic Oncology: Seminars and Original Investigations, 03.07.2016.

Research output: Contribution to journalArticle

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title = "National treatment trends among older patients with T1-localized renal cell carcinoma 1 1Dr. Simon P. Kim is supported by a career development award from the Conquer Cancer Foundation from the American Society of Clinical Oncology",
abstract = "Objective: To assess the national trends in treatment of localized renal tumors among older patients with limited life expectancy. Materials and methods: Using the National Cancer Database, we identified older patients (≥70. y) diagnosed with T1 renal cell carcinoma from 2002 to 2011. Primary outcome was the initial treatment-partial nephrectomy (PN), radical nephrectomy, EM, and ablation. Multivariable logistic regression analysis stratified by tumor size (<2, 2-3.9, or 4-7. cm) and age groups (70-79 and ≥80. y) was used to identify covariates associated with different treatments. Results: Among 41,518 older patients with T1 renal cell carcinoma renal tumors, most were treated with radical nephrectomy (59.0{\%}) followed by PN (20.0{\%}) and ablation (8.4{\%}). Only 12.6{\%} were managed by EM. Among older patients aged 70 to 79 years with renal tumors 2 to 3.9. cm, PN was used more frequently in 2008 to 2009 (odds ratio [OR] = 1.32; . P = 0.001) and 2010 to 2011 (OR = 1.87; . P<0.001) compared to 2002 to 2003 and at academic hospitals (OR = 1.91; . P<0.001) compared to community hospitals. Similar trends were observed for patients aged 70 to 79 years with 4 to 7. cm tumors and for patients aged≥80 years across renal tumor sizes. Conclusions: Among older patients with localized renal tumors and limited life expectancy, most are treated surgically with a growing use of PN. A smaller proportion of older patients are managed by EM in the United States.",
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T1 - National treatment trends among older patients with T1-localized renal cell carcinoma 1 1Dr. Simon P. Kim is supported by a career development award from the Conquer Cancer Foundation from the American Society of Clinical Oncology

AU - Kim, Simon P.

AU - Gross, Cary P.

AU - Meropol, Neal

AU - Kutikov, Alexander

AU - Smaldone, Marc C.

AU - Shah, Nilay D

AU - Yu, James B.

AU - Psutka, Sarah

AU - Kiechle, Jonathon

AU - Abouassaly, Robert

PY - 2016/7/3

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N2 - Objective: To assess the national trends in treatment of localized renal tumors among older patients with limited life expectancy. Materials and methods: Using the National Cancer Database, we identified older patients (≥70. y) diagnosed with T1 renal cell carcinoma from 2002 to 2011. Primary outcome was the initial treatment-partial nephrectomy (PN), radical nephrectomy, EM, and ablation. Multivariable logistic regression analysis stratified by tumor size (<2, 2-3.9, or 4-7. cm) and age groups (70-79 and ≥80. y) was used to identify covariates associated with different treatments. Results: Among 41,518 older patients with T1 renal cell carcinoma renal tumors, most were treated with radical nephrectomy (59.0%) followed by PN (20.0%) and ablation (8.4%). Only 12.6% were managed by EM. Among older patients aged 70 to 79 years with renal tumors 2 to 3.9. cm, PN was used more frequently in 2008 to 2009 (odds ratio [OR] = 1.32; . P = 0.001) and 2010 to 2011 (OR = 1.87; . P<0.001) compared to 2002 to 2003 and at academic hospitals (OR = 1.91; . P<0.001) compared to community hospitals. Similar trends were observed for patients aged 70 to 79 years with 4 to 7. cm tumors and for patients aged≥80 years across renal tumor sizes. Conclusions: Among older patients with localized renal tumors and limited life expectancy, most are treated surgically with a growing use of PN. A smaller proportion of older patients are managed by EM in the United States.

AB - Objective: To assess the national trends in treatment of localized renal tumors among older patients with limited life expectancy. Materials and methods: Using the National Cancer Database, we identified older patients (≥70. y) diagnosed with T1 renal cell carcinoma from 2002 to 2011. Primary outcome was the initial treatment-partial nephrectomy (PN), radical nephrectomy, EM, and ablation. Multivariable logistic regression analysis stratified by tumor size (<2, 2-3.9, or 4-7. cm) and age groups (70-79 and ≥80. y) was used to identify covariates associated with different treatments. Results: Among 41,518 older patients with T1 renal cell carcinoma renal tumors, most were treated with radical nephrectomy (59.0%) followed by PN (20.0%) and ablation (8.4%). Only 12.6% were managed by EM. Among older patients aged 70 to 79 years with renal tumors 2 to 3.9. cm, PN was used more frequently in 2008 to 2009 (odds ratio [OR] = 1.32; . P = 0.001) and 2010 to 2011 (OR = 1.87; . P<0.001) compared to 2002 to 2003 and at academic hospitals (OR = 1.91; . P<0.001) compared to community hospitals. Similar trends were observed for patients aged 70 to 79 years with 4 to 7. cm tumors and for patients aged≥80 years across renal tumor sizes. Conclusions: Among older patients with localized renal tumors and limited life expectancy, most are treated surgically with a growing use of PN. A smaller proportion of older patients are managed by EM in the United States.

KW - Advanced age

KW - Kidney cancer

KW - Nephrectomy

KW - Renal cell carcinoma

KW - Treatment decisions

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